Diabetes affects a large and diverse number of individuals who share in common its risks for complications but who differ greatly from one another in age, health, and a number of circumstances influential to successful treatment. Because type 2 diabetes comprises the majority of diabetes cases, a number of agents have been developed for its treatment. Their unique properties offer opportunities to overcome some of the treatment limitations of older medicines and enable a more individualized and flexible approach to glucose-lowering. At the same time, new medications are accompanied by greater costs and uncertainties about their long-term benefits or safety, and thus the present state of care for type 2 diabetes places focus on a process of shared decision-making between the clinician and patient as to which treatments can optimize health while minimizing harms. We review the major classes of diabetes agents and provide some guidance for how one might approach decision-making in choosing among them.
The growing number of therapies available for diabetes allows for better individualization of care, providing more balance between the benefits and side effects of treatment.
Department of Medicine, Section of Endocrinology, Yale University School of Medicine, New Haven, Connecticut.
Corresponding author: Silvio E. Inzucchi, MD, Department of Medicine, Section of Endocrinology, Yale University School of Medicine, PO Box 208020, 333 Cedar Street, New Haven, CT 06520-8020; e-mail: firstname.lastname@example.org.
Financial Disclosure Dr. Inzucchi is a consultant or advisor to Merck, Boehringer Ingelheim, Janssen, Novo-Nordisk, Astra-Zeneca, and Sanofi and received research support from Takeda (study supplies). Dr. Majumdar did not report any potential conflicts of interest.
Continuing medical education for this article is available at http://links.lww.com/AOG/A779.